Individual
MS. NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
5905 OLD DAWSON RD, ALBANY, GA 31721-9173
(229) 869-6625
Mailing address
5905 OLD DAWSON RD, ALBANY, GA 31721-9173
(229) 869-6625
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002150
GA
Other
Enumeration date
11/18/2007
Last updated
11/18/2007
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